A client with type 2 diabetes takes 10 units of Insulin glargine each evening at 2300. She asks the home care nurse on call if she should take her dose this evening because she has had a fever to 101.2 F (38.4 C). diarrhea & "can't hold anything on my stomach." since yesterday The nurse replies

Yes, take it. There's a risk you could develop dangerously high blood sugar because of your fever.

No, do not take it this evening. You could get hypoglycemic before this morning.

Yes, take the dose. Check your blood glucose in the evening & the morning when you wake up.

No, do not take your dose. You must set an alarm & check your glucose level every 4 hours.

Answer and Explanation

The Correct Answer is A

A. Yes, take it. There's a risk you could develop dangerously high blood sugar because of your fever: Even though the client is experiencing fever and diarrhea, these conditions can cause stress on the body, which in turn can increase blood sugar levels. Fever and illness often result in elevated blood sugar levels due to the body's release of stress hormones like cortisol and adrenaline, which raise blood glucose. Therefore, the nurse should advise the client to take their insulin to prevent hyperglycemia. The nurse should also recommend the client to monitor their blood glucose more frequently during illness.

B. No, do not take it this evening. You could get hypoglycemic before this morning: Insulin glargine is a long-acting basal insulin, and it does not cause rapid or quick peaks in blood sugar levels. It is unlikely to cause hypoglycemia unless the client does not eat or is taking excessive doses. It is more important to control potential hyperglycemia during illness.

C. Yes, take the dose. Check your blood glucose in the evening & the morning when you wake up: The client should take their insulin, but the nurse should also suggest more frequent blood glucose checks, especially every 4 hours, rather than just evening and morning checks. Illness and fever can cause fluctuations in blood sugar, so more monitoring is necessary.

D. No, do not take your dose. You must set an alarm & check your glucose level every 4 hours: The client should continue taking their insulin to manage blood glucose levels, especially during illness, to prevent hyperglycemia. Checking blood glucose every 4 hours is important, but withholding insulin could worsen the situation by increasing the risk of hyperglycemia.

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Correct Answer is ["A","B"]

Explanation

A. Heart failure: An anterior wall myocardial infarction (MI) often affects the left ventricle, which is responsible for pumping oxygenated blood to the body. Damage to this area can impair the heart's ability to pump effectively, leading to heart failure. Left-sided heart failure is a common complication following an anterior wall MI.

B. Ventricular dysrhythmias: The anterior wall of the left ventricle is part of the area most vulnerable to ischemic damage during an MI. This damage can disrupt the electrical conduction system of the heart, leading to ventricular dysrhythmias, which are serious and life-threatening complications, particularly following an anterior wall MI.

C. Cor pulmonale: Cor pulmonale refers to right-sided heart failure caused by chronic lung disease, such as COPD or pulmonary hypertension. It is not typically a complication of an anterior wall MI. Anterior wall MIs primarily affect left-sided heart function.

D. Increased bleeding: Increased bleeding is not a typical complication of an anterior wall MI. While patients with MI may be treated with anticoagulants, bleeding is not directly related to the myocardial infarction itself. Instead, complications like heart failure, arrhythmias, or rupture of the ventricular wall are more commonly associated with an anterior wall MI.

Correct Answer is ["342.9"]

Explanation

To calculate the IV pump rate in mL/hr, use the formula:

Rate (mL/hr) = (Total Volume in mL ÷ Time in minutes) × 60

Given:

Volume = 200 mL

Time = 35 minutes

Rate = (200 ÷ 35) × 60 = 5.7143 × 60 = 342.86

Rounded to the nearest tenth:

342.9 mL/hr

The nurse should set the IV pump to 342.9 mL/hr.

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A client with type 2 diabetes takes 10 units of Insulin glargine each evening at 2300. She asks the home care nurse on call if she should take her dose this evening because she has had a fever to 101.2 F (38.4 C). diarrhea & "can't hold anything on my stomach." since yesterday The nurse replies

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient who has had an anterior wall MI. Which of the following complications should the nurse assess for in this patient? (Select All that Apply.)

Correct Answer is ["A","B"]

Explanation

A client is ordered to receive a bolus of 200 mL of NSS in 35 minutes. At what rate should the nurse set the IV pump? (Use a preceding zero if necessary. Do not use trailing zeros. Round to the nearest tenth if necessary)

Correct Answer is ["342.9"]

Explanation

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